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Hepatic Medicine: Evidence and Research

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https://www.readbyqxmd.com/read/27843363/defibrotide-in-the-treatment-of-hepatic-veno-occlusive-disease
#1
REVIEW
Alessandro Fulgenzi, Maria Elena Ferrero
Hepatic veno-occlusive disease (VOD), also known as sinusoidal obstruction syndrome (SOS), represents the most frequent complication in patients in early phase following hematopoietic stem-cell transplantation (HSCT). In its severe form, VOD/SOS can be associated with multiorgan failure and with a mortality rate >80% by day +100. Defibrotide (DF) (a mixture of 90% single-stranded phosphodiester oligonucleotides and 10% double-stranded phosphodiester oligonucleotides derived from controlled depolarization of porcine intestinal mucosal DNA) has been proposed for the treatment of SOS due to its ability to restore thrombo-fibrinolytic balance and protect endothelial cells...
2016: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/27695370/presence-and-consequence-of-tooth-periapical-radiolucency-in-patients-with-cirrhosis
#2
Lea Ladegaard Grønkjær, Palle Holmstrup, Søren Schou, Kristoffer Schwartz, Johanne Kongstad, Peter Jepsen, Hendrik Vilstrup
BACKGROUND: Periapical radiolucency is the radiographic sign of inflammatory bone lesions around the apex of the tooth. We determined the prevalence and predictors of periapical radiolucency in patients with cirrhosis and the association with systemic inflammation status and cirrhosis-related complications. METHODS: A total of 110 cirrhosis patients were consecutively enrolled. Periapical radiolucency was defined as the presence of radiolucency or widening of the periapical periodontal ligament space to more than twice the normal width...
2016: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/27621676/obeticholic-acid-for-the-treatment-of-primary-biliary-cholangitis-in-adult-patients-clinical-utility-and-patient-selection
#3
REVIEW
Christopher L Bowlus
Primary biliary cholangitis (PBC), previously known as primary biliary "cirrhosis", is a rare autoimmune liver disease characterized by the hallmark autoantibodies to mitochondrial antigens and immune-mediated destruction of small bile duct epithelial cells leading to cholestasis and cirrhosis. Surprisingly, while immune modulators have not been effective in the treatment of PBC, supplementation with the hydrophilic bile acid (BA) ursodeoxycholic acid (UDCA) has been demonstrated to slow the disease progression...
2016: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/27555800/idiopathic-noncirrhotic-portal-hypertension-current-perspectives
#4
REVIEW
Oliviero Riggio, Stefania Gioia, Ilaria Pentassuglio, Valeria Nicoletti, Michele Valente, Giulia d'Amati
The term idiopathic noncirrhotic portal hypertension (INCPH) has been recently proposed to replace terms, such as hepatoportal sclerosis, idiopathic portal hypertension, incomplete septal cirrhosis, and nodular regenerative hyperplasia, used to describe patients with a hepatic presinusoidal cause of portal hypertension of unknown etiology, characterized by features of portal hypertension (esophageal varices, nonmalignant ascites, porto-venous collaterals), splenomegaly, patent portal, and hepatic veins and no clinical and histological signs of cirrhosis...
2016: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/27418860/role-of-ledipasvir-sofosbuvir-combination-for-genotype-1-hepatitis-c-virus-infection
#5
REVIEW
Vinay Sundaram, Kris V Kowdley
Chronic hepatitis C virus (HCV) infection is one of the most common etiologies of liver-related mortality throughout the world. Among the six HCV genotypes, genotype 1 was significantly more aggressive when utilizing the combination of pegylated interferon and ribavirin, as genotype 1-infected patients had the lowest likelihood of achieving cure (40%-50%) and required twice as long duration of treatment, as compared to genotypes 2 and 3. Recently, however, significant advances have been made with the advent of all-oral direct-acting antiviral agents, which have significantly improved the safety, efficacy, and tolerability of the treatment of HCV genotype 1...
2016: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/27382341/transarterial-chemoembolization-with-drug-eluting-beads-versus-conventional-transarterial-chemoembolization-in-locally-advanced-hepatocellular-carcinoma
#6
Johannes Baur, Christian O Ritter, Christoph-Thomas Germer, Ingo Klein, Ralph Kickuth, Ulrich Steger
PURPOSE: In hepatocellular carcinoma patients with large or multinodal tumors, where curative treatment options are not feasible, transarterial therapies play a major role. Transarterial chemoembolization (TACE) with drug-eluting beads (DEB-TACE) is a promising new approach due to higher intratumoral and lower systemic concentration of the chemotherapeutic agent compared to conventional TACE (cTACE). PATIENTS AND METHODS: In a retrospective analysis, 32 patients with hepatocellular carcinoma who received either DEB or a cTACE were compared regarding survival time, disease recurrence, and side effects such as pain and fever...
2016: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/27274322/paritaprevir-ritonavir-ombitasvir-and-dasabuvir-the-3d-regimen-for-the-treatment-of-chronic-hepatitis-c-virus-infection-a-concise-review
#7
REVIEW
Trana Hussaini
The treatment for chronic hepatitis C has been revolutionized with the development of direct-acting antiviral agents. Several regimens have been approved and are currently used in clinical practice, treating a wide range of patient populations infected with hepatitis C. The interferon-free combination of paritaprevir/ritonavir-ombitasvir and dasabuvir (PrOD or the three-drug [3D] regimen) with or without ribavirin is indicated for the treatment of chronic hepatitis C in both treatment-naïve and experienced patients infected with genotype 1, including those coinfected with HIV and patients post-liver transplantation...
2016: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/27217802/hepatitis-c-in-the-russian-federation-challenges-and-future-directions
#8
REVIEW
Sergey Mukomolov, Galina Trifonova, Irina Levakova, Daria Bolsun, Eugenia Krivanogova
Hepatitis C virus (HCV) infection is one of the most prevalent health problems in the world. Official registration of HCV infections in the Russian Federation started in 1994. Two clinical forms of infection - acute and chronic hepatitis C - are registered separately. Moreover, the HCV national surveillance system also includes reports from laboratories on results from testing ∼20 population risk groups for antibodies to HCV; approximately 15-16 million tests are performed annually. Modern epidemiological features of HCV infection in the Russian Federation are characterized by low incidence of the acute form of infection (acute HCV; one to two per 100,000) and a dramatic increase in chronic HCV (CHCV) cases...
2016: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/27186144/the-pathophysiology-of-thrombocytopenia-in-chronic-liver-disease
#9
REVIEW
Oscar Mitchell, David M Feldman, Marla Diakow, Samuel H Sigal
Thrombocytopenia is the most common hematological abnormality encountered in patients with chronic liver disease (CLD). In addition to being an indicator of advanced disease and poor prognosis, it frequently prevents crucial interventions. Historically, thrombocytopenia has been attributed to hypersplenism, which is the increased pooling of platelets in a spleen enlarged by congestive splenomegaly secondary to portal hypertension. Over the past decade, however, there have been significant advances in the understanding of thrombopoiesis, which, in turn, has led to an improved understanding of thrombocytopenia in cirrhosis...
2016: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/27099536/autophagy-a-new-target-for-nonalcoholic-fatty-liver-disease-therapy
#10
REVIEW
Yuqing Mao, Fujun Yu, Jianbo Wang, Chuanyong Guo, Xiaoming Fan
Nonalcoholic fatty liver disease (NAFLD) has gained importance in recent decades due to drastic changes in diet, especially in Western countries. NAFLD occurs as a spectrum from simple hepatic steatosis, steatohepatitis to cirrhosis, and even hepatocellular carcinoma. Although the molecular mechanisms underlying the development of NAFLD have been intensively investigated, many issues remain to be resolved. Autophagy is a cell survival mechanism for disposing of excess or defective organelles, and has become a hot spot for research...
2016: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/27019602/daclatasvir-sofosbuvir-combination-therapy-with-or-without-ribavirin-for-hepatitis-c-virus-infection-from-the-clinical-trials-to-real-life
#11
REVIEW
Stanislas Pol, Marion Corouge, Anaïs Vallet-Pichard
The treatment of hepatitis C virus has changed dramatically with the rapid advent of numerous new antiviral agents, including direct-acting antivirals and agents with non-viral targets (cyclophilin inhibitors, interferon-lambda, vaccine therapy). Given the better safety profile and high antiviral potency of direct-acting antivirals, their combination in interferon-free oral regimens is becoming the standard of care for hepatitis C virus infection, tailored to individual patients according to the degree of disease progression (fibrosis), hepatitis C virus genotype and subtype, resistance profile, and prior therapeutic history...
2016: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/26955295/autophagy-in-hepatocellular-carcinomas-from-pathophysiology-to-therapeutic-response
#12
REVIEW
Srikanta Dash, Srinivas Chava, Partha K Chandra, Yucel Aydin, Luis A Balart, Tong Wu
Autophagy is an intracellular lysosomal degradation process performed by the cells to maintain energy balance. The autophagy response plays an important role in the progression of liver disease due to hepatitis virus infection, alcoholic liver disease, nonalcoholic fatty liver disease, liver cirrhosis, and hepatocellular carcinoma (HCC). An increased autophagy response also contributes to the pathogenesis of liver disease through modulation of innate and adaptive immune responses; a defective cellular autophagy response leads to the development of HCC...
2016: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/26889091/challenging-hepatitis-c-infected-liver-transplant-patients
#13
REVIEW
Madeleine Oliver, Christopher Chiodo Ortiz, Jorge Ortiz
Caring for liver transplant patients suffering from chronic hepatitis C virus (HCV) infection is a challenging task for transplant surgeons and primary physicians alike. HCV is the leading cause of liver transplantation in the USA and comes with a myriad of complications that increase morbidity and mortality. This review focuses on patient follow-up, spanning from before the liver transplant occurs to the patient's long-term health. Pretransplant, both donor and recipient variables, must be carefully chosen to ensure optimal surgical success...
2016: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/26586969/association-of-cytokine-gene-polymorphisms-with-hepatitis-c-virus-infection-in-a-population-from-rio-de-janeiro-brazil
#14
Gustavo Milson Fabrício-Silva, Bruno Silva Poschetzky, Renata de Mello Perez, Ronaldo Carneiro Dos Santos, Luciana Tricai Cavalini, Luís Cristóvão Porto
BACKGROUND: The host immune response is an important indicator of the outcome of hepatitis C virus (HCV) infection and disease progression. The aim of this study was to explore cytokine gene polymorphisms as a candidate for susceptibility to persistent HCV infection or HCV spontaneous clearance in a population from Rio de Janeiro, Brazil. METHODS: Genetic polymorphisms in the cytokines, tumor necrosis factor-alpha (-308), transforming growth factor-beta 1 (codons 10 and 25), interleukin-10 (IL-10; -1082 and -592), IL-6 (-174), and interferon-gamma (+874) were analyzed by polymerase chain reaction sequence-specific primers in 245 patients with chronic hepatitis C (CHC), 41 spontaneous recovery (SR) patients, and 189 healthy volunteers...
2015: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/26586968/interferon-free-combination-therapies-for-the-treatment-of-hepatitis-c-current-insights
#15
REVIEW
Jacinta A Holmes, Alexander J Thompson
The hepatitis C virus (HCV) treatment landscape has rapidly changed over the past 5 years. The development of direct-acting antiviral (DAA) agents that specifically target various steps in the HCV lifecycle has revolutionized therapeutic options for patients with HCV, with the development of highly effective and well-tolerated oral interferon-free regimens. There are many DAAs that are currently in development or have recently been approved, which target different nonstructural HCV proteins and host targets that are essential for HCV replication...
2015: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/26203291/management-options-in-decompensated-cirrhosis
#16
REVIEW
Neeral L Shah, Yasmin Pourkazemi Banaei, Kristen L Hojnowski, Scott L Cornella
Chronic injury to the liver from a variety of different sources can result in irreversible scarring of the liver, known as cirrhosis. Cirrhosis is a major cause of morbidity and mortality in the USA, and according to the Centers for Disease Control and Prevention was responsible for 31,903 deaths in 2010 alone. It is thus of the utmost importance to appropriately manage these patients in the inpatient and outpatient setting to improve morbidity and mortality. In this review, we address four major areas of cirrhosis management: outpatient management of portal hypertension with decompensation, hepatic encephalopathy, hepatorenal syndrome, and bleeding/coagulation issues...
2015: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/26203290/overt-hepatic-encephalopathy-in-italy-clinical-outcomes-and-healthcare-costs
#17
Daniela Paola Roggeri, Alessandro Roggeri, Elisa Rossi, Elisa Cinconze, Antonio Gasbarrini, PierAlessandro Monici Preti, Marisa De Rosa
PURPOSE: Hepatic encephalopathy (HE) is a recurrent severe complication of progressive hepatic cirrhosis. The aim of this study is to evaluate the average annual direct healthcare costs for the treatment of patients with overt HE in Italy. PATIENTS AND METHODS: This retrospective, observational study analyzed information from the database of ARNO Observatory. Patients with at least one hospitalization due to overt HE in the period from January 1, 2011 to December 31, 2011, were selected and observed during the year following the hospitalization...
2015: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/26082668/tyrosine-levels-are-associated-with-insulin-resistance-in-patients-with-nonalcoholic-fatty-liver-disease
#18
Miwa Kawanaka, Ken Nishino, Takahito Oka, Noriyo Urata, Jun Nakamura, Mitsuhiko Suehiro, Hirofumi Kawamoto, Yasutaka Chiba, Gotaro Yamada
OBJECTIVE: Amino acid imbalance is often found in patients with cirrhosis, and this imbalance is associated with insulin resistance. However, the mechanism underlying the relationship between amino acid imbalance and insulin resistance remains unclear. We evaluated serum amino acid concentrations in patients with nonalcoholic fatty liver disease to determine if any of the levels of amino acids were associated with the biochemical markers and fibrosis stage of nonalcoholic steatohepatitis (NASH)...
2015: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/26056497/percutaneous-hepatic-radiofrequency-for-hepatocellular-carcinoma-results-and-outcome-of-46-patients
#19
Julie Bertrand, Fabrice Caillol, Patrick Borentain, Jean-Luc Raoul, Laurent Heyries, Erwan Bories, Christian Pesenti, Jean-Philippe Ratone, Jean-Paul Bernard, René Gerolami, Marc Giovannini
Radiofrequency ablation (RFA) is a curative option for hepatocellular carcinoma (HCC), the most common primary malignancy of the liver. This bicentric retrospective study includes 46 patients admitted for their first percutaneous RFA for HCC. Sixty-three nodules were treated, with an average size of 32.5 mm. Our study confirms the efficiency of this technique for attaining necrosis of HCC nodules, with few complications. Subgroup studies according to RFA mode (mono- or multipolar), etiology of cirrhosis (alcoholic or viral), and HCC size showed better efficiency for multipolar RFA when applied to small tumors and better survival when the cirrhosis was due to viral infection...
2015: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/25926761/should-ns5a-inhibitors-serve-as-the-scaffold-for-all-oral-anti-hcv-combination-therapies
#20
REVIEW
Sujit V Janardhan, Nancy S Reau
Chronic hepatitis C virus (HCV) infection represents a global health problem that affects up to 130-150 million people worldwide. The HCV treatment landscape has been transformed recently by the introduction of direct-acting antiviral (DAA) agents that target viral proteins, including the NS3 protease, the NS5B polymerase, and the NS5A protein. Treatment with multiple DAAs in combination has been shown to result in high rates of sustained virologic response, without the need for pegylated interferon, and a shorter duration of therapy compared with interferon-based regimens; however, the optimal combination of DAAs has yet to be determined...
2015: Hepatic Medicine: Evidence and Research
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